Currently the licensing of professionals such as doctors, surgeons, engineers and others, occurs across several years of course curriculum, technique practice and perhaps simulations. In particular, hand-on, practical exams are difficult to assess. These sessions are observed by an examiner or teacher and rated qualitatively by that person. After several years of training and education a paper based record with the cumulative comments of all teachers is submitted to a licensing or certification authority. The decision to grant a license is measured against a set of standards based on the qualitative description of an applicant's training as well as on the quantitative grading system used.
There are several drawbacks of this traditional approach. One drawback is that the authority granting the license or certification may never have actually observed this professional's techniques nor expertise and is basing the decision mostly on the qualitative assessments of the student's teachers and examiners.
Another drawback is that for a class of many students there are likely several different examiners. Each examiner will have slightly different standards and experience and will grade students differently using their own set of different subjective standards.
To ensure consistency and fairness, practical examinations may be recorded or videotaped by various methods. However, this approach has the limitation that it is difficult to ensure the content veracity of the recording. Digital and analog files may be altered and edited and this tampering can be very difficult to detect. Tests, questionnaires, and surveys may be accessed surreptitiously in advance. As well, evaluation results may also be tampered with. To ensure a fair evaluation, a licensing or certification authority must be sure that recordings and results have not been tampered with and that it shows the performance of the actual student performing the procedure or exam on the date indicated.